Clinicopathological characterization of so-called "cholangiocarcinoma with intraductal papillary growth" with respect to "intraductal papillary neoplasm of bile duct (IPNB)"

Yasuni Nakanuma, Yasunori Sato, Hidenori Ojima, Yae Kanai, Shinichi Aishima, Masakazu Yamamoto, Shun ichi Ariizumi, Toru Furukawa, Hiroki Hayashi, Michiaki Unno, Tetsuo Ohta, Hirohito Tsubouchi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Cholangiocarcinoma (CC) of the biliary tract occasionally presents a predominant intraductal papillary growth in the bile ducts, called as biliary tract carcinoma (BTC) of papillary growth (PG) and intrahepatic CC (ICC) of intraductal growth (IG) type. Recently, intraductal papillary neoplasm of bile duct (IPNB) has been proposed as a pre-invasive biliary neoplasm. This study was performed to characterize pathologically BTC of PG type and ICC of IG type with respect to IPNB. It was found that 126 of such 154 CCs (81.8%) fulfilled the criteria of IPNB, while the remaining 28 cases showed different histologies, such as tubular adenocarcinoma and carcinosarcoma. These IPNBs occurred in old aged patients with a male predominance, and the left lobe was rather frequently affected in the liver. A majority of these cases were high grade IPNB (43 cases) and invasive IPNB (77 cases), while low grade IPNB was rare (6 cases). Pancreatobiliary type was predominant (48 cases) followed by gastric (30 cases), intestinal (29 cases) and oncocytic (19 cases) types. Mucus hypersecretion was found in 45 cases, and this was frequent in IPNB at the intrahepatic large bile duct and hilar bile ducts but rare at the extrahepatic bile ducts. Interestingly, 36 cases of high grade and invasive IPNBs contained foci of moderately differentiated adenocacinoma within the intraductal papillary tumor. In conclusion, a majority of ICC of IG type and BTC of PG type could be regarded as a IPNB lineage, and clinically detectable IPNBs were already a malignant papillary lesion.

Original languageEnglish
Pages (from-to)3112-3122
Number of pages11
JournalInternational Journal of Clinical and Experimental Pathology
Volume7
Issue number6
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Bile Duct Neoplasms
Cholangiocarcinoma
Biliary Tract
Growth
Papillary Carcinoma
Bile Ducts
Carcinosarcoma
Intrahepatic Bile Ducts
Extrahepatic Bile Ducts
Mucus
Neoplasms
Stomach
Histology
Adenocarcinoma
Liver

Keywords

  • Biliary tree
  • Intraductal cholangiocarcinoma
  • Intraductal papillary neoplasm
  • Papillary cholangiocarcinoma
  • Phenotype

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Medicine(all)

Cite this

Clinicopathological characterization of so-called "cholangiocarcinoma with intraductal papillary growth" with respect to "intraductal papillary neoplasm of bile duct (IPNB)". / Nakanuma, Yasuni; Sato, Yasunori; Ojima, Hidenori; Kanai, Yae; Aishima, Shinichi; Yamamoto, Masakazu; Ariizumi, Shun ichi; Furukawa, Toru; Hayashi, Hiroki; Unno, Michiaki; Ohta, Tetsuo; Tsubouchi, Hirohito.

In: International Journal of Clinical and Experimental Pathology, Vol. 7, No. 6, 2014, p. 3112-3122.

Research output: Contribution to journalArticle

Nakanuma, Yasuni ; Sato, Yasunori ; Ojima, Hidenori ; Kanai, Yae ; Aishima, Shinichi ; Yamamoto, Masakazu ; Ariizumi, Shun ichi ; Furukawa, Toru ; Hayashi, Hiroki ; Unno, Michiaki ; Ohta, Tetsuo ; Tsubouchi, Hirohito. / Clinicopathological characterization of so-called "cholangiocarcinoma with intraductal papillary growth" with respect to "intraductal papillary neoplasm of bile duct (IPNB)". In: International Journal of Clinical and Experimental Pathology. 2014 ; Vol. 7, No. 6. pp. 3112-3122.
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AU - Nakanuma, Yasuni

AU - Sato, Yasunori

AU - Ojima, Hidenori

AU - Kanai, Yae

AU - Aishima, Shinichi

AU - Yamamoto, Masakazu

AU - Ariizumi, Shun ichi

AU - Furukawa, Toru

AU - Hayashi, Hiroki

AU - Unno, Michiaki

AU - Ohta, Tetsuo

AU - Tsubouchi, Hirohito

PY - 2014

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AB - Cholangiocarcinoma (CC) of the biliary tract occasionally presents a predominant intraductal papillary growth in the bile ducts, called as biliary tract carcinoma (BTC) of papillary growth (PG) and intrahepatic CC (ICC) of intraductal growth (IG) type. Recently, intraductal papillary neoplasm of bile duct (IPNB) has been proposed as a pre-invasive biliary neoplasm. This study was performed to characterize pathologically BTC of PG type and ICC of IG type with respect to IPNB. It was found that 126 of such 154 CCs (81.8%) fulfilled the criteria of IPNB, while the remaining 28 cases showed different histologies, such as tubular adenocarcinoma and carcinosarcoma. These IPNBs occurred in old aged patients with a male predominance, and the left lobe was rather frequently affected in the liver. A majority of these cases were high grade IPNB (43 cases) and invasive IPNB (77 cases), while low grade IPNB was rare (6 cases). Pancreatobiliary type was predominant (48 cases) followed by gastric (30 cases), intestinal (29 cases) and oncocytic (19 cases) types. Mucus hypersecretion was found in 45 cases, and this was frequent in IPNB at the intrahepatic large bile duct and hilar bile ducts but rare at the extrahepatic bile ducts. Interestingly, 36 cases of high grade and invasive IPNBs contained foci of moderately differentiated adenocacinoma within the intraductal papillary tumor. In conclusion, a majority of ICC of IG type and BTC of PG type could be regarded as a IPNB lineage, and clinically detectable IPNBs were already a malignant papillary lesion.

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